[W enterocystoplasty with resorbable staples: technic and functional results. Preliminary study].

Introduction: The use of absorbable staples for enterocystoplasty allows a marked reduction of the operating time. The long-term results on continence need to be evaluated at result term before adopting this technique.

Methods: Eight patients underwent "W" enterocystoplasty performed with absorbable staples according to the so-called "Detroit" technique, with direct uretero-ileal anastomosis.

[Anatomic study of the pubic-urethral ligaments in women: role of urethral suspension].

Objective: In 1963, the studies by Zacharin emphasized the importance of the suspensory apparatus of the female urethra, consisting of two non-extensible fibrous bands composed of 3 distinct ligaments. The objectives of this study were to evaluate the role of these ligaments in support of the urethra and to define the value of their preservation in cystectomy with bladder replacement in women.

Material And Methods: Five fresh female cadavres with a mean age 78 years (range: 75-82) were used for dissection of the suspensory apparatus of the urethra via a suprapubic then sagittal approach by section of the pelvis 2 cm from the midline.

[Treatment of ureteral stenosis using high pressure dilatation catheters].

Introduction: High-pressure dilatation catheters have been proposed as an alternative to open surgery in the treatment of ureteric strictures because of the low morbidity and short hospital stay. The objective of this study was to evaluate the results of this technique in patients with inflammatory ureteric strictures or uretero-ileal strictures.

Methods: From April 1991 to September 1996, 25 strictures were treated by antegrade or retrograde dilatation with a high-pressure balloon catheter followed by stenting with a double J stent for an average of 2.

Value of the preoperative detection of prostate-specific-antigen-positive circulating cells by nested RT-PCR in patients submitted to radical prostatectomy.

Objective: To assess the value of the detection of circulating prostate cells [prostate-specific antigen (PSA) positive] by reverse-transcriptase nested polymerase chain reaction (nested RT-PCR) to improve the staging of clinically localized prostate cancer.

Methods: Nested PCR was performed on blood samples of 29 patients submitted to radical prostatectomy for clinically localized (T1-T2) prostate cancer. Nine patients with various benign urologic diseases comprised the negative control group.

[Post-treatment PSA, indicator of radical treatment effectiveness of localized cancer of the prostate].

Prostate specific antigen (PSA) has become essential to the follow-up of radical treatment for T1-T2 tumours. Various assays are available, but require a correlation coefficient to homogenize their results. PSA is probably the most reliable marker for the follow-up of radical prostatectomy (RP), as this operation should make PSA undetectable after 3 weeks.

A role for cadherins in tissue formation.

We have produced null mutant mouse embryonic stem cells for the cell adhesion molecule E-cadherin. Such E-cadherin-/- ES cells are defective in cell aggregation; this defect can be corrected by transfection with cDNA for either E-cadherin or N-cadherin driven by a constitutive promoter. The presence (or absence) of E-cadherin regulates the expression of the transcription factor T-brachyury, indicating that cadherins play a role in linking cell surface receptors and gene expression.

[Urinary infections in pregnant women].

Urinary tract infection is frequent during pregnancy with a high potential risk for mother and child. Based on a review of the literature and a retrospective survey conducted in 20 representative French university hospitals during 1993, the authors propose a practical review designed to standardize the therapeutic approach to this disease. They define a high-risk group which requires systematic screening and close surveillance during pregnancy.

Micturition disturbances and human immunodeficiency virus infection.

Purpose: Human immunodeficiency virus (HIV) infections often lead to urological disorders, including tumors, infections and micturitional disturbances. It often is difficult to identify the origin of voiding disorders but the most frequent causes are infections (prostatitis and so forth), obstruction (cervico-prostatic or urethral) and neurological (encephalitis, myelitis, polyradiculoneuritis and so forth). We determined the etiologies, therapy and clinical outcome of micturitional disturbances in the acquired immunodeficiency syndrome.

[Does the proportion of tumor tissue in biopsies reflect the extent of localized prostate cancer?].

Objectives: To evaluate whether the percentage of biopsy tissue invaded by tumour provides any supplementary information to laboratory and/or biopsy data (Gleason, number...

Prostate specimen reevaluation in patients with organ confined prostate cancer and postoperative biological recurrence.

Purpose: We evaluated whether detectable levels of prostate specific antigen after radical prostatectomy for stage P2 disease are associated with unconfined cancer overlooked at pathological examination.

Materials And Methods: Among 129 patients with stages T1 and T2 prostate cancer treated with radical prostatectomy 60 had stage P2 disease. The initial slides from the 7 patients with biological failure were carefully reviewed and, if necessary, the embedded blocks were sectioned every 2 mm.

A single positive prostate biopsy in six does not predict a low-volume prostate tumour.

Objective: To evaluate whether a single positive prostate biopsy in six systematic transrectal ultrasonography (TRUS)-guided biopsies is predictive of a small tumour volume in a subsequent radical prostatectomy (RP) specimen.

Patients And Methods: Of 158 patients submitted to RP for T1-T2 prostate cancer, 15.2% had one positive biopsy.

Early detection of prostate cancer in men with prostatism and intermediate prostate-specific antigen levels.

Objectives: To determine the prevalence of prostate cancer and the diagnostic ability of prostate-specific antigen density (PSAD) in men with lower urinary tract symptoms and intermediate prostate-specific antigen (PSA) levels of 4 to 10 ng/mL (Hybritech assay) and to assess the clinical significance of prostate cancers in men who subsequently underwent radical prostatectomy.

Methods: Six systematic transrectal ultrasonography (TRUS)-guided biopsies were performed in 153 symptomatic men (mean age, 66 years) with PSA levels between 4 and 10 ng/mL, irrespective of digital rectal examination (DRE) findings. Prostate volume was also determined by TRUS and PSAD was calculated (serum PSA divided by volume of entire prostate).

[Detection of prostatic cancer in symptomatic patients with serum levels of prostate-specific antigen between 4 and 10 ng/ml].

Objectives: Determine the incidence of prostate cancer in patients consulting for common miction disorders and serum prostatic specific antigen (PSA) between 4 and 10 ng/ml.

Methods: A total of 153 patients consulted for miction disorders. In 107 of them, the digital examination was abnormal and PSA was between 4 and 10 ng/ml.

[A single positive prostatic biopsy out of six systematic biopsies is not correlated with the intracapsular nature of the tumor on an individual level].

Objective: To evaluate whether or not a single positive prostatic biopsy out of six systematic ultrasound-guided biopsies, is reliably correlated manner with favourable histopathological features of the tumour on the radical prostatectomy (RP) specimen.

Materials And Methods: In a series of 158 patients undergoing RP for clinically localized prostatic cancer, 15.2% had only one positive biopsy out of 6 systematic biopsies.

Ventral tethering of the vagina and its role in the kinetics of urethra and bladder-neck straining.

Based on the principle that the urethra forms an integral part of the ventral wall of the vagina, the aim of this study was to determine the elements of fixation of this wall and their role in the maintenance of urethral statics during strain exertion. Eight dissections of the female pelvis were performed by a simultaneous high and low approach. The anatomic data were compared with a study of the kinetics of the urethra by dynamic MRI.

Advances in the assessment of clinically localized prostate cancer.

Objective: We review the advances in pathology, biology, and radiology which could improve the detection of extracapsular prostate cancer preoperatively.

Method: The experiences of others are compared to ours to give a topical overview of advances in the assessment of clinically localized prostate cancer.

Results: Despite new technologies, such as colour Doppler and endorectal magnetic resonance imaging, radiology does not enhance the ability to detect small invasion through the prostatic capsule.

Anatomic basis of mesenteric elongation for ileo-anal anastomosis with J-shaped reservoir: comparison of two techniques of vascular section.

Total proctocolectomy followed by ileo-anal anastomosis with a reservoir is the operation of choice for the treatment of familial adenomatous polyposis and of certain forms of hemorrhagic proctocolitis. Vascular section is sometimes necessary to enable the extremity of the reservoir to reach the anal sphincter without traction. The aim of this study was to compare the gain in length obtained by two different techniques of vascular section and to assess in terms of the vascular anatomy of the last small intestinal loop which technique best preserved the vascularisation of the reservoir as a whole.

[Anatomopathologic reassessment of prostatic tumors exclusively affecting the organ with biologic progression and survival study of prostatectomized patients, in terms of the histologic characteristics of the tumor].

Objectives: The coexistence of tumours confined to the prostate and laboratory signs of progression is surprising unless we accept the possibility of errors of the pathological examination. In view of the high incidence of laboratory signs of progression after radical prostatectomy, it is important to define the most pejorative histological features in order to improve patient selection.

Methods: 129 radical prostatectomy specimens were studied, 8 out of 129 patients, with an immediate or secondary elevation of PSA while histological examination diagnosed a pT2 intracapsular cancer, were re-evaluated by reviewing the slides and resection of paraffin embedded blocks of prostate.

[Priapism in the adult: report of 15 cases].

Objectives: The practical approach to the treatment of priapism is complicated by the rarity of this disease. Treatments for impotence by intracavernous injection of vasodilators have considerably increased the incidence of prolonged erections, although "antidote" protocols, when instituted rapidly, ensure detumescence in most cases. The objective of this study was to define a practical and rigorous approach based on comparison of our results with those reported in the literature concerning the management of priapism.

Clearance of serum PSA after open surgery for benign prostatic hypertrophy, radical cystectomy, and radical prostatectomy.

Objective: To study the clearance of serum prostate-specific antigen (PSA) after several types of prostatic tissue ablation.

Methods: Serum PSA levels were measured (YANG Proscheck ultrasensitive assay) just before surgery, immediately after specimen removal, then twice weekly for 5 weeks or until it was undetectable (< 0.05 ng/ml) in patients undergoing radical cystoprostatectomy for bladder cancer (n = 10), or radical prostatectomy for T1 T2 prostate cancer (n = 18) and daily for 6 days after open surgery for benign prostatic hypertrophy (BPH) (n = 10).

Effect of radiation therapy after radical prostatectomy on serum prostate-specific antigen measured by an ultrasensitive assay.

Objectives: To study prospectively the impact of adjuvant radiation therapy on the serum level of prostate-specific antigen (PSA), as measured by an ultrasensitive Yang Proscheck assay in patients with detectable serum PSA and a negative metastatic survey after radical prostatectomy for T1 or T2 prostate cancer.

Methods: Seventeen patients had a detectable serum PSA (2.40 +/- 2.

[Initial clinical experiences with the Storz Modulith SL 20 lithotripter: the results 3 months after a single session].

The objective of this study was to evaluate the performances of the Storz Modulith SL20 lithotriptor. Fifty patients with a total of 52 renal (31) or ureteric (21) stones were treated, in a single session, between June and October 1993. The mean stone diameter was 7.

Perineal versus retropubic radical prostatectomy for T1, T2 prostate cancer.

Objective: To compare retrospectively the efficacy of radical perineal and retropubic prostatectomy in patients with T1, T2 cancer of the prostate.

Patients And Methods: From January 1991 to January 1993, 71 patients with T1, T2 carcinoma of the prostate aged 52-74 years underwent radical retropubic prostatectomy (36) or radical perineal prostatectomy (35); this was preceded by endosurgical lymphadenectomy. The two groups were identical with regard to age (64 vs 66 years), clinical stage (T1a 17% vs 25%, T2 82% vs 74%), mean and median pre-operative prostate-specific antigen (PSA) (20 vs 26, 11 vs 15 using the YANG polyclonal assay n < 2.